BILL NUMBER: AB 1820	CHAPTERED  09/14/00

	CHAPTER   440
	FILED WITH SECRETARY OF STATE   SEPTEMBER 14, 2000
	APPROVED BY GOVERNOR   SEPTEMBER 13, 2000
	PASSED THE ASSEMBLY   AUGUST 25, 2000
	PASSED THE SENATE   AUGUST 24, 2000
	AMENDED IN SENATE   AUGUST 23, 2000
	AMENDED IN SENATE   AUGUST 10, 2000
	AMENDED IN SENATE   AUGUST 7, 2000
	AMENDED IN SENATE   JUNE 27, 2000
	AMENDED IN SENATE   JUNE 14, 2000
	AMENDED IN ASSEMBLY   MAY 11, 2000
	AMENDED IN ASSEMBLY   MAY 2, 2000
	AMENDED IN ASSEMBLY   MARCH 23, 2000

INTRODUCED BY   Assembly Member Wright
   (Principal coauthors:  Assembly Members Alquist and Shelley)
   (Coauthors:  Assembly Members Davis, Firebaugh, Jackson,
Longville, Machado, Mazzoni, Strom-Martin, Washington, Wayne,
Wildman, and Zettel)
   (Coauthors:  Senators Alarcon, Alpert, Chesbro, Escutia, Hughes,
McPherson, Murray, Soto, Speier, and Vasconcellos)

                        FEBRUARY 3, 2000

   An act to amend Sections 2183 and 2191.2 of, to add Sections
2190.2 and 2190.3 to, and to repeal Section 2179.5 of, the Business
and Professions Code, and to amend Sections 105105 and 105120 of, and
to add Sections 105101 and 105112 to, to repeal Section 105135 of,
and to repeal and add Section 105100 of, the Health and Safety Code,
relating to geriatric medicine.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 1820, R. Wright.  Geriatric medicine.
   Existing law requires adequate instruction in certain specified
subjects, including geriatric medicine, as required curriculum for
medical students applying for a physician's and surgeon's
certificate.
   This bill would enact the "Geriatric Medical Training Act of 2000."
  It would provide that the University of California should develop
and implement a geriatric medicine program and curriculum for its
medical schools, as soon as possible, but no later than September 1,
2003.  The bill would request that the Regents of the University of
California first submit a progress report to the Legislature no later
than March 30, 2003, followed by a report on the status of the
implementation of the geriatric medicine program and curriculum at
each campus to the Legislature no later than March 30, 2004.
Subsequently, the bill would request that the regents submit a report
every 5 years, commencing no later than June 30, 2005, describing
progress in geriatric training and related initiatives at each
campus.  This bill would express the intent of the Legislature that
the professors occupying endowed chairs in geriatric medicine at the
University of California that were funded in the 2000-01 Budget Act
provide leadership in developing and implementing the expanded
geriatric programs and curriculum, and that the one-time funds
provided to the Academic Geriatric Resource Program in the 2000-01
Budget Act also be used to implement the provisions of this bill.
The bill would make related changes and specify certain legislative
findings and declarations.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:


  SECTION 1.  This act shall be known as, and may be cited as, the
Geriatric Medical Training Act of 2000.
  SEC. 2.  Section 2179.5 of the Business and Professions Code is
repealed.
  SEC. 3.  Section 2183 of the Business and Professions Code is
amended to read:
   2183.  An applicant for a physician's and surgeon's certificate
shall pass the national examination for medical licensure in
biomedical sciences and clinical sciences, including geriatric
medicine, determined by the Division of Licensing to be essential for
the unsupervised practice of medicine.
   An applicant who applies for a physician's and surgeon's
certificate on or after January 1, 2004, shall have completed
coursework in geriatric medicine in medical school or in postgraduate
medical education training.
  SEC. 4.  Section 2190.2 is added to the Business and Professions
Code, to read:
   2190.2.  The Division of Licensing shall establish criteria that
providers of continuing medical education shall follow to ensure
attendance by licensees throughout the entire course.
  SEC. 5.  Section 2190.3 is added to the Business and Professions
Code, to read:
   2190.3.  All general internists and family physicians who have a
patient population of which over 25 percent are 65 years of age or
older shall complete at least 20 percent of all mandatory continuing
education hours in a course in the field of geriatric medicine or the
care of older patients.
  SEC. 6.  Section 2191.2 of the Business and Professions Code is
amended to read:
   2191.2.  The division shall encourage every physician and surgeon
to take a course in geriatric medicine, including geriatric
pharmacology, as part of his or her continuing education.
  SEC. 7.  Section 105100 of the Health and Safety Code is repealed.

  SEC. 8.  Section 105100 is added to the Health and Safety Code, to
read:
   105100.  The Legislature finds and declares all of the following:

   (a) In 1998, there were about 3.57 million Californians age 65 and
older, a 15 percent increase since 1990.  This number will at least
increase to five million in 2010 and grow to seven million by 2020,
with those persons over age 85 representing the fastest growing
segment of the population.
   (b) By 2020, the numbers of Hispanic, African American, and other
minority older persons will more than quadruple to an estimated total
of at least 2.8 million.
   (c) The age group over 75 has the highest rate of health care
utilization of all groups.
   (d) The higher prevalence of chronic conditions in those age 65
and older results in greater use of physician services.  On average,
they visit a physician nine times a year compared to five visits by
the general population.  They are hospitalized over three times as
often as the younger population, stay 50 percent longer, and use
twice as many prescription drugs.
   (e) The knowledge and skill base in geriatrics, which is essential
to the provision of medical care to older patients, has not been
adequately integrated into the training of today's doctors and other
health care professionals.
   (f) If resources are not invested now for better training in
geriatrics, there will be an inadequate supply of doctors properly
trained to treat older patients by 2010.
   (g) The Academic Geriatric Resource Program was established in
1984 as a mechanism for developing within the University of
California new educational initiatives in geriatrics, gerontology,
and other disciplines relating to aging.  The program originally was
funded at one million dollars ($1,000,000).  Funding has not kept
pace with inflation or need.  The program in 1999 was funded at one
million one hundred thousand dollars ($1,100,000).
   (h) The Association of American Medical Colleges acknowledged the
problem of inadequate medical education in geriatrics in December
1999 by launching a new program to enhance the gerontology and
geriatric curricula at United States medical schools.  The
association recognized that geriatrics should "be represented in a
more coherent and comprehensive manner in the curricula of all U.S.
medical schools."
  SEC. 9.  Section 105101 is added to the Health and Safety Code, to
read:
   105101.  It is the intent of the Legislature that the University
of California provide academic courses and training in the field of
geriatrics for medical students and existing general internists and
family physicians in order to ensure that every general internist and
family physician, along with other professions, have the requisite
knowledge and skills to competently treat the older population by the
year 2010 when the baby boomer generation begins to retire.
  SEC. 10.  Section 105105 of the Health and Safety Code is amended
to read:
   105105.  It is the purpose of the Legislature, in enacting this
chapter, for the University of California to establish academic
geriatric resource programs and encourage the development of expanded
educational and community service programs in geriatric medicine at
its medical schools or other health science campuses.  A
multidisciplinary approach shall be utilized in the development of
these programs.  The programs shall include, but not be limited to,
one or more of the following elements:
   (a) Preclinical, clinical, or postgraduate educational programs in
geriatrics for health science students to instruct and train them in
recognizing and responding to the needs and dynamics of the health
care of older patients.
   (b) Provision of continuing education in geriatrics for health
care providers and the general public.
   (c) A teaching nursing home program to research nursing home
health care practices and to instruct and train health science
students about geriatric care.
   (d) Development and evaluation of the best practices for the
health care of older persons.
   (e) Development and evaluation of interdisciplinary models of
geriatric training.
   (f) Development and evaluation of innovative health care delivery
sites and programs for older persons.
  SEC. 11.  Section 105120 of the Health and Safety Code is amended
to read:
   105120.  The Legislature requests that, on March 30, 2001, and
biennially thereafter, the Regents of the University of California
submit a progress report to the Legislature, including copies to the
members of the Assembly Committee on Aging and Long-Term Care, the
members of the Senate Health and Human Services Subcommittee on Aging
and Long-Term Care, and the Chairpersons of the Assembly Committee
on Budget and the Senate Committee on Budget and Fiscal Review,
regarding the grant programs established pursuant to this chapter.
The report should include, but not be limited to, all of the
following elements:
   (a) A description of the progress made in implementing and
maintaining the programs.
   (b) The number of academic geriatric resource programs
established.
   (c) The characteristics and costs of the programs.
   (d) A summary of the progress towards developing and implementing
educational and community service programs in geriatric medicine at
each campus.
   (e) An evaluation of the program's effectiveness at each campus,
including identification of problems and limitations, and strategies
to overcome them.
   The report should separately delineate the information required
pursuant to this section with respect to each medical or health
science campus that receives funding under a grant program
established pursuant to this chapter.
  SEC. 12.  Section 105112 is added to the Health and Safety Code, to
read:
   105112.  (a) It is the intent of the Legislature that University
of California medical students complete a definable curriculum in
geriatric medicine over the course of their medical school training
to meet recommended core competencies for the care of older persons.
It is the intent of the Legislature that this curriculum instill the
attitudes, knowledge, and skills that physicians need to provide
competent and compassionate care for older persons, including both
didactic and clinical experiences encompassing the spectrum of health
status of older persons and community-based sites for clinical
training.
   (b) It is the intent of the Legislature that University of
California medical residents in internal medicine, family practice,
and psychiatry complete a definable curriculum in geriatric medicine
over the course of their residency training.  It is the intent of the
Legislature that this curriculum instill the attitudes, knowledge,
and skills that physicians practicing these specialties need to
provide competent and compassionate care for older persons.  This
curriculum should encompass the spectrum of health status of older
persons and include community-based sites for clinical training.
   (c) It is the intent of the Legislature that the University of
California be responsible for developing, implementing, maintaining,
and evaluating the geriatric medicine content needed in the
curriculum.  The curriculum shall take into consideration the
recommendations of the Institute of Medicine of the National Academy
of Sciences, the American Geriatric Society, and other nationally
recognized medical organizations.  The expanded geriatric medicine
program and curriculum should be developed and implemented at each
University of California school of medicine as soon as possible, but
no later than September 1, 2003.
   (d) The Legislature requests that, no later than March 30, 2003,
the Regents of the University of California submit a progress report
on the status of the implementation of a definable curriculum in
geriatric medicine at each campus in accordance with this act.
   (e) The Legislature requests that, no later than March 30, 2004,
the Regents of the University of California submit a report on the
status of the implementation of a definable curriculum in geriatric
medicine at each campus.  The report should include the total number
of hours of geriatric instruction to be given at each school of
medicine and the number of weeks of that instruction or experience
provided at each medical school.  This report should be written by a
committee that is specifically charged with reporting on the status
of the implementation of this section.  The majority of committee
members should be national experts in the geriatric field who are not
University of California employees.
   (f) The Legislature requests that every 5 years, commencing no
later than June 30, 2005, the Regents of the University of California
submit a report describing progress in geriatrics training and
related initiatives at each campus in accordance with the act.  This
report should be written by a committee that is specifically charged
with evaluating this progress.  The majority of committee members
should be national experts in the geriatric field who are not
University of California employees.
   (g) Copies of the reports requested in subdivisions (d), (e), and
(f) are to be submitted to the members of the Assembly Committee on
Aging and Long-Term Care, the members of the Senate Health and Human
Services Subcommittee on Aging and Long-Term Care, and the
Chairpersons of the Assembly Committee on Budget and the Senate
Committee on Budget and Fiscal Review.
   (h) It is the intent of the Legislature that the professors
occupying the University of California endowed chairs in geriatric
medicine funded in the 2000-01 Budget Act provide leadership in
developing and implementing the expanded geriatric medicine programs
and curriculum at the University of California, and that one-time
funds provided to the Academic Geriatric Resource Program in the
2000-01 Budget Act also be used to expand geriatric medicine programs
and curriculum at the University to implement subdivisions (a) and
(b) of Section 105112 of the Health and Safety Code.
  SEC. 13.  Section 105135 of the Health and Safety Code is repealed.
